This document discusses the importance of breastfeeding for infant health in Cambodia and challenges with breastfeeding support. It finds that exclusive breastfeeding rates in Cambodia are low, with only 36% of mothers receiving support and breastmilk substitute use nearly doubling from 2000 to 2010. Despite laws regulating marketing of breastmilk substitutes, violations are common, with 86% of mothers seeing promotions. The document calls for media to help promote optimal breastfeeding practices through education and monitoring compliance with laws protecting breastfeeding.

1. Kampong Thom Hospital, 2013, UNICEF Cambodia
Breastfeeding: The evidence is clear
Breastfeeding gives children the best start in life. Initiating
breastfeeding within one hour of birth can prevent about 20 percent
of newborn deaths.1 Infants exclusively breastfed for six months are
11 times less likely to die from diarrhea and 15 times less likely to
die from pneumonia.1,2 Longer duration of breastfeeding is also
linked with higher intelligence, school achievement, and earning
ability.3
Despite this, Cambodian mothers are not receiving the breastfeeding
support they need:
•• The consumption of breastmilk substitutes among children
under 2 years nearly doubled between 2000 and 2010
(from 4.8 percent to 9.3 percent).4
•• Only 36 percent of Cambodian mothers reported receiving
breastfeeding counseling and support from health providers.5
•• Thirty-three percent of children between 6 and 24 months
from the urban quintile were fed with breastmilk substitutes.4
•• Twenty-five percent of women delivering in private clinics
used infant formula, which is three times more than women
delivering in the public sector.4
PROMOTING AND PROTECTING BREASTFEEDING IN CAMBODIA:
THE ROLE OF THE MEDIA IN SUPPORTING SUB-DECREE 133
• Initiation of breastfeeding within
1 hour of birth
• Exclusive breastfeeding for the
first 6 months of life
• Continued breastfeeding for 2
years and beyond along with
nutritionally adequate, safe,
age appropriate, responsive
complementary feeding starting
after six months8
Optimal breastfeeding
practices include:

2. The Media is Essential to Protecting Optimal Breastfeeding Practices in
Cambodia
Media can be an effective and credible channel to elevate the importance of infant and young child feeding (IYCF) and to
build momentum through a steady drumbeat of information and focus on IYCF. In addition, media personnel and outlets
have a key role to play in monitoring and reporting violations of Sub-Decree 133 and the Joint Prakas No 061 across
Cambodia. By promoting and protecting breastfeeding, we can ensure that all mothers and families receive the very best,
unbiased information to help them choose the safest, healthiest, and most nourishing method of feeding their children.
What can the Media do to Support Sub-Decree 133?
•• Promote the benefits of early, exclusive and continued breastfeeding across media platforms, including traditional,
digital and social media channels
•• Develop and execute a training for all reporters and journalists to increase their knowledge and awareness
of both the issue of child undernutrition in Cambodia, as well as the ongoing threat of breastmilk substitute
companies to optimal infant and young child feeding
•• Encourage more frequent and impactful reporting on early child nutrition issues and code violations
•• Donate airtime and other media real estate to publish educational content on the benefits of breastfeeding and the
harms of breastmilk substitute products
•• Consider canceling or not renewing contracts with a BMS companies
International Policy for Breastfeeding Promotion6
Because marketing of breast milk substitutes can interfere with a mother’s decision to breastfeed, the World Health
Assembly adopted The International Code of Marketing of Breastmilk Substitutes (BMS Code) in 1981. The Code and
subsequent World Health assembly resolutions promote and protect breastfeeding by prohibiting the promotion of any
breastmilk substitute as a partial or total replacement of breastmilk.
Cambodia’s Sub-Decree No
133 and Joint Prakas No
0617
Adopted in 2005, the Sub-Decree regulates the marketing of breastmilk substitute products by limiting how and where
companies can advertise and market products to parents of young children. The Joint Prakas No 061, signed in 2007,
instructed the MOH, the Ministry of Commerce, the Ministry of Industry, Mines and Energy, and the Ministry of Information
to jointly implement, monitor, and enforce the Sub-Decree No 133. Restrictions include:
•• Advertising and marketing of infant and young child feeding products
•• Labeling of feeding products for children under 2 years, including complementary foods
•• Advertising and marketing of feeding bottles and rubber and plastic teats
Violations of the Sub-Decree are Common in Cambodia9,10,11
Though the Royal Government of Cambodia has taken strong
steps to safeguard infant and young child health and nutrition
through the national Sub-Decree 133 and Joint Prakas No 061,
breastmilk substitute companies continue to violate its marketing
and advertising provisions and adopt marketing practices that
are explicitly banned in the country.
•• In Phnom Penh, 86 percent of mothers with a child
under 24 months of age reported having seen, heard,
or read a commercial promotion of infant and young
child feeding products; 77 percent of mothers reported
seeing one on television. 5
•• From September 2013 to 2014, 10 of 16 TV
channels monitored in Phnom Penh, Cambodia had
advertisements for breast-milk substitutes (BMS). 5
WHERE TO REPORT VIOLATIONS
Attn: Secretariat of the Executive Working Group, AING Hoksrun, Pharm, Msc., Chief of Food Safety Bureau,
Department of Drugs and Food, Ministry of Health, No. 80 Samdech Pen Nuth Blvd, Toulkok, Phnom Penh, Cambodia,
Tel: +855 85 538 066 l Fax/Phone: + 855 23 880 248 l E-mail: hoksrunaing@gmail.com
Footnote
1. Begum, K., Dewey, K., Alive Thrive Insight, “Impact of early initiation of
exclusive breastfeeding on newborn deaths,” 2010.
2. Barros, A., et al., The Lancet, Vol. 379, “Countdown to 2015: a retrospective
review of survey data from 54 countries: equity in maternal, newborn, and child
health interventions,” 2012.
3. Victora, C., et al., The Lancet Global Health, 3 (4): e199, “Association between
breastfeeding and intelligence, educational attainment, and income at 30 years of
age: a prospective birth cohort study from Brazil,” 2015.
4. Prak, S., et al., Nutrients 2014, 6, 2920-2930, “Breastfeeding Trends in
Cambodia, and the Increased Use of Breast-Milk Substitute—Why Is It a Danger?.”
5. Assessment of Promotion of Foods Consumed by Infants and Young Children in
Phnom Penh: Assessment and Research on Child Feeding (ARCH) – Cambodia
Country Report, Helen Keller International, 2015.
6. World Health Organization, “International Code of Marketing of Breast-milk
Substitutes,” 1981.
7. Royal Government of Cambodia, “Sub-Decree 133 on Marketing of Products for
Infant and Young Child Feeding” and “Joint Prakas 061 on Implementation of
Sub-Decree on Marketing of Products for Infant and Young Child Feeding,” 2005
and 2007.
8. Holla, R., et al., BPNI and IBFAN, “The Need to Invest in Babies report,” 2013.
9. Save the Children, Helen Keller International, UNICEF, World Health Organization,
World Vision, “Joint Statement on breast milk substitutes in Cambodia,” May
2014.
10. Bearup, S., Justice and International Mission Unit, “Unethical Marketing of Infant
Formula and Breastmilk Substitutes in Cambodia 2009,” 2009.
11. IBFAN, “Report on the Situation of Infant and Young Child Feeding in
Cambodia,” 2011.